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1.
J Hand Surg Glob Online ; 6(2): 159-163, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38903845

RESUMO

Purpose: Injury to the scapholunate (SL) interosseous ligament (SLIL) is a common cause of carpal instability. Internal brace augmentation has been used in various ligament repair procedures; however, further investigation of its outcomes in hand surgery is needed. This study aimed to examine outcomes for patients who underwent SLIL repair with internal brace augmentation. Methods: Patients who underwent SLIL repair with the internal brace technique and had at least 1 year of follow-up were contacted. Available patients returned for an in-person evaluation with new radiographs and physical examination. If patients could not be contacted but had x-rays and physical examinations performed at greater than 1 year after surgery, these data were collected from their medical records. Participating patients completed the QuickDASH and Patient-Rated Wrist Evaluation surveys and rated their satisfaction with the surgery. Outcomes assessed included wrist range of motion, grip strength, scaphoid shift test, SL gap, SL angle, and radiographic evidence of radiocarpal arthritis. Results: We collected outcomes for 14 SLIL repairs among 13 patients (12 male). Mean length of the follow-up was 41 months (n = 14, 17-64). Mean QuickDASH and Patient-Rated Wrist Evaluation scores were 6.1 (0-43.2) and 9.6 (0-65), respectively. Radiographic measurements remained stable from immediate to latest follow-up, and no radiocarpal arthritic changes were noted. However, SL gap decreased from a mean of 5.33 mm (3.4-6.7) before surgery to 3.34 mm (2-4.6) at the latest follow-up, and SL angle decreased from a mean of 79.5° (67°-97°) before surgery to 67.3° (51°-85°) at the latest follow-up. All scaphoid shift tests were stable. Conclusions: Therefore, SL internal brace augmentation has favorable short-term results with improvements in pain, function, satisfaction, and carpal alignment at greater than 1 year postoperatively. This technique can be an effective option for the management of SL instability in the short term. Type of study/level of evidence: Therapeutic IV.

2.
Spine Deform ; 12(5): 1337-1343, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38689179

RESUMO

PURPOSE: To perform a cross-cultural adaptation and validation of the Brazilian-Portuguese versions of the Brace Questionnaire in adolescent idiopathic scoliosis. METHODS: A forward-backward translation process was employed to produce a Brazilian Portuguese version of the Brace Questionnaire, followed by comprehensive cross-cultural adaptation stages. The measurements of internal consistency and test-retest reliability were assessed by Cronbach's a and intraclass correlation coefficient (ICC), respectively. The Pearson's correlation coefficient was used to analyze the concurrent validity by comparison with the Scoliosis Research Society-22r questionnaire. RESULTS: A total of 84 scoliosis patients (age 13.4 ± 2.0 years, thoracic Cobb angle 33.3° ± 13.8°, and lumbar Cobb angle 29.8° ± 14.3°) were included. The Brace Questionnaire showed excellent internal consistency (Cronbach α = 0.93) and moderate reliability (ICC = 0.86). The correlations between the Brace Questionnaire and Scoliosis Research Society-22 were r = 0.66; p = 0.011. In addition, it was found that the Brazilian version of the Brace Questionnaire does not have ceiling and floor effects. CONCLUSIONS: The Brazilian-Portuguese adaptation of the brace questionnaire shows excellent reliability and can be a valid tool for psychometric assessment in adolescent idiopathic scoliosis.


Assuntos
Braquetes , Comparação Transcultural , Psicometria , Escoliose , Traduções , Humanos , Escoliose/psicologia , Adolescente , Brasil , Inquéritos e Questionários/normas , Feminino , Masculino , Reprodutibilidade dos Testes , Criança , Idioma
3.
Medicina (Kaunas) ; 58(8)2022 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-36013490

RESUMO

Background and Objectives: Adolescent idiopathic scoliosis (AIS) is a prevalent spinal disorder in adolescents. Previous studies have shown biomechanical changes of the gait in the lower limb of AIS patients. To minimize the progression of scoliotic curvature, a spinal brace is used, which has been shown to be efficient. Usually, a brace is worn strictly for 20-22 h every day. To our knowledge, no study has assessed the short- and long-term effects of spinal brace use with or without an exercise program (6 months) to improve clinical and biomechanical parameters. The aim of our study was to verify the effects of short- and long-term spinal brace use, with or without an exercise program on the spine, body balance, and plantar load distribution during gait in AIS. Materials and Methods: A prospective randomized study was conducted with intention-to-treat analysis in forty-five adolescents diagnosed with AIS undergoing conservative treatment at a center specialized in spinal rehabilitation. Adolescents were evaluated at two stages of intervention: (1) spinal orthopedic brace, with acute use 24 h/day (n = 22) and (2) spinal orthopedic brace, with acute use between 15-18 h/day associated with a specific rehabilitation exercise protocol for six consecutive months (six months and 12 total sessions, n = 23). The evaluated parameters were: spine pain, using a visual analog scale (VAS); Cobb angle measurement using radiograph exams, as well as the Risser sign; and static balance and plantar pressure of the feet during gait, carried out using a pressure platform. Results: AIS patients showed significant improvements in the main scoliotic curvature, with a 12-degree reduction in Cobb angle pre- and post-short-term immediate use of spinal brace and a 5.3 degree correction after six months of spinal brace use in combination with specific exercises (long term). In addition, short- and long-term brace use with an exercise program showed a significant increase in anteroposterior and mediolateral balance and a reduction in plantar overload on the heel during gait, with an effect size between moderate and high. Conclusions: Intervention via the short- or long-term use of a spinal brace combined with specific exercises in adolescents with idiopathic scoliosis proved to be effective for correcting scoliotic curvature. In addition, intervention also showed improvements to the antero-posterior and mediolateral body balance and a reduction in the plantar load on the rearfoot region during gait, demonstrating effective mechanical action on the spine.


Assuntos
Cifose , Escoliose , Adolescente , Braquetes , Marcha , Humanos , Estudos Prospectivos , Escoliose/complicações , Escoliose/terapia , Coluna Vertebral
4.
Medwave ; 21(3): e8115, 2021 Apr 28.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-34038401

RESUMO

INTRODUCTION: Knee osteoarthritis is a relevant health problem given its high prevalence and associated disability. Within the non-pharmacological management alternatives, the use of offloader knee braces has been proposed, however, there is no consensus in the literature regarding its indication. METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified 14 systematic reviews including nine studies overall, all of which were randomized trials. We conclude that the use of offloader knee braces in patients with knee osteoarthritis probably increases physical function through walking distance. However, its use may make little or no difference to physical function measured with the Hospital for Special Surgery Knee score, it may slightly worsen the quality of life and increase adverse events, but the certainty of the evidence is low. In addition, we are uncertain whether the use of offloader knee braces reduces pain as the certainty of the evidence has been assessed as very low.


INTRODUCCIÓN: La artrosis de rodilla es una enfermedad degenerativa que constituye un problema de salud relevante dada su alta prevalencia y discapacidad asociada. Dentro de las alternativas de manejo no farmacológico se ha planteado el uso de órtesis de rodilla, sin embargo no existe consenso en la literatura respecto a su utilidad. MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis, preparamos tablas de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos 14 revisiones sistemáticas que en conjunto incluyeron nueve estudios primarios, de los cuales, todos corresponden a ensayos aleatorizados. Concluimos que el uso de órtesis de rodilla con refuerzo en descarga en pacientes con artrosis de rodilla probablemente aumenta la funcionalidad medida a través de la distancia caminada. Sin embargo, podría resultar en poca o nula diferencia sobre la funcionalidad evaluada con Hospital for Special Surgery Knee score, podría empeorar levemente la calidad de vida y aumentar los efectos adversos, pero la certeza de la evidencia es baja. Además, no es posible establecer con claridad si el uso de órtesis de rodilla disminuye el dolor dado que la certeza de la evidencia fue evaluada como muy baja.


Assuntos
Braquetes , Osteoartrite do Joelho/terapia , Abordagem GRADE , Humanos , Dor/prevenção & controle , Qualidade de Vida , Revisões Sistemáticas como Assunto , Resultado do Tratamento
5.
Rev. urug. cardiol ; 35(3): 133-172, dic. 2020.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1145080

RESUMO

Resumen: La necesidad de distanciamiento social impuesta por la actual pandemia por coronavirus obligó a las diferentes sociedades científicas a realizar sus actividades en formato completamente virtual. La Sociedad Europea de Cardiología no ha sido la excepción. Desde el 29 de agosto al 1 de septiembre de 2020 se celebró este evento sin precedentes que, además de contar con 125.000 profesionales de 213 países, permitió el acceso gratuito a todos los cibernautas. De esta manera, la actualidad en cardiología pudo llegar a todos los rincones del mundo, pese a las circunstancias tan complejas. Como ya es tradición de la revista, realizamos un resumen de los principales ensayos presentados durante el congreso: - Early Rhythm-Control Therapy in Patients with Atrial Fibrillation (EAST-AFNET 4) - Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure (The EMPEROR-Reduced Trial Investigators) - Efficacy and Safety of Mavacamten in Adults with Symptomatic Obstructive Hypertrophic Cardiomyopathy (EXPLORER-HCM) - Angiotensin Receptor Neprilysin Inhibition Compared with Individualized Medical Therapy for Comorbidities in Patients with Heart Failure and Preserved Ejection Fraction (The PARALLAX Trial) - A Study to Evaluate the Effect of Dapagliflozin on Renal Outcomes and Cardiovascular Mortality in Patients with Chronic Kidney Disease (DAPA-CKD) - Aspirin with or without Clopidogrel after Transcatheter Aortic-Valve Implantation (POPULAR TAVI (Cohort A)) - Colchicine in Patients with Chronic Coronary Disease (The LoDoCo2 Trial Investigators) - Pharmacological Blood Pressure-Lowering for Primary and Secondary Prevention of Cardiovascular Disease Across Different Levels of Blood Pressure (BPLTTC) - Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (The BRACE CORONA Trial) - Randomized Trial of Transfusion Strategies in Patients with Myocardial Infarction and Anemia (REALITY Trial)


Summary The need for social distancing imposed by the current coronavirus pandemic, forced the different scientific societies to carry out their activities in a completely virtual format. And the European Society of Cardiology has not been the exception. From August 29 to September 1 of 2020, this unprecedented event was held which, in addition to having 125,000 health professionals from 213 countries, allowed free access to all netizens. In this way, current affairs in cardiology could reach all corners of the world, despite such complex circumstances. As is the tradition of the magazine, we present a summary of the main essays presented during the congress: - Early Rhythm-Control Therapy in Patients with Atrial Fibrillation (EAST-AFNET 4) - Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure (The EMPEROR-Reduced Trial Investigators) - Efficacy and Safety of Mavacamten in Adults with Symptomatic Obstructive Hypertrophic Cardiomyopathy (EXPLORER-HCM) - Angiotensin Receptor Neprilysin Inhibition Compared with Individualized Medical Therapy for Comorbidities in Patients with Heart Failure and Preserved Ejection Fraction (The PARALLAX Trial) - A Study to Evaluate the Effect of Dapagliflozin on Renal Outcomes and Cardiovascular Mortality in Patients with Chronic Kidney Disease (DAPA-CKD) - Aspirin with or without Clopidogrel after Transcatheter Aortic-Valve Implantation (POPULAR TAVI (Cohort A)) - Colchicine in Patients with Chronic Coronary Disease (The LoDoCo2 Trial Investigators) - Pharmacological Blood Pressure-Lowering for Primary and Secondary Prevention of Cardiovascular Disease Across Different Levels of Blood Pressure (BPLTTC) - Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (The BRACE CORONA Trial) - Randomized Trial of Transfusion Strategies in Patients with Myocardial Infarction and Anemia (REALITY Trial)


Resumo A necessidade de distanciamento social imposto pela atual pandemia do coronavírus, obrigou as diferentes sociedades científicas a desenvolverem suas atividades de forma totalmente virtual. E a Sociedade Europeia de Cardiologia não foi exceção. De 29 de agosto a 1º de setembro 2020, foi realizado esse evento inédito que, além de contar com 125.000 profissionais de saúde de 213 países, possibilitou o acesso gratuito a todos os internautas. Dessa forma, a atualidade da cardiologia pode atingir todos os cantos do mundo, apesar de circunstâncias tão complexas. Como é tradição da revista, apresentamos um resumo dos principais ensaios apresentados durante o congresso: - Early Rhythm-Control Therapy in Patients with Atrial Fibrillation (EAST-AFNET 4) - Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure (The EMPEROR-Reduced Trial Investigators) - Efficacy and Safety of Mavacamten in Adults with Symptomatic Obstructive Hypertrophic Cardiomyopathy (EXPLORER-HCM) - Angiotensin Receptor Neprilysin Inhibition Compared with Individualized Medical Therapy for Comorbidities in Patients with Heart Failure and Preserved Ejection Fraction (The PARALLAX Trial) - A Study to Evaluate the Effect of Dapagliflozin on Renal Outcomes and Cardiovascular Mortality in Patients with Chronic Kidney Disease (DAPA-CKD) - Aspirin with or without Clopidogrel after Transcatheter Aortic-Valve Implantation (POPULAR TAVI (Cohort A)) - Colchicine in Patients with Chronic Coronary Disease (The LoDoCo2 Trial Investigators) - Pharmacological Blood Pressure-Lowering for Primary and Secondary Prevention of Cardiovascular Disease Across Different Levels of Blood Pressure (BPLTTC) - Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (The BRACE CORONA Trial) - Randomized Trial of Transfusion Strategies in Patients with Myocardial Infarction and Anemia (REALITY Trial)

6.
Braz J Phys Ther ; 24(4): 342-348, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31175006

RESUMO

OBJECTIVE: To determine the immediate effects of a varus unloader knee brace on lower-limb electromyographic activity in individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction. METHODS: Electromyographic data were recorded in 19 individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction during walking under three conditions: (i) no brace, (ii) unadjusted brace (no varus adjustment), and adjusted brace (varus adjustment). Variables of interest were statistically analyzed using repeated measures analysis of variance. RESULTS: There were no significant differences in muscle co-contraction between the three test conditions. The adjusted brace resulted in delayed offset of gluteus maximus (mean difference [95% CI]: 72ms [24, 119]), and earlier onset of gluteus medius (59ms [21, 97]) compared to no brace. The adjusted brace delayed onset of lateral gastrocnemius compared to no brace (53ms [28, 78]) and the unadjusted brace (39ms [7, 71]) and reduced average activation amplitude of gluteus maximus (-4mV [-6, -1]) and lateral gastrocnemius (-9mV [-16, -2]) compared to no brace. CONCLUSIONS: The unloader brace did not produce significant changes in muscle co-contraction in individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction. Significant changes in gluteal and gastrocnemius muscle activation timing and amplitude were observed, however, it is not clear whether these changes are of clinical importance.


Assuntos
Reconstrução do Ligamento Cruzado Anterior/métodos , Extremidade Inferior/fisiologia , Contração Muscular/fisiologia , Músculo Esquelético/fisiopatologia , Osteoartrite do Joelho/fisiopatologia , Braquetes , Humanos , Caminhada/fisiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-30564635

RESUMO

BACKGROUND: Bracing is used as a valid non-surgical treatment for adolescent idiopathic scoliosis (AIS) to avoid progression of the deformity and thereby surgery. The effect of bracing treatment on quality of life of patients with AIS has been a topic of interest in the international literature. The aim of this study was to evaluate the quality of life and patient satisfaction during bracing treatment for AIS of a pediatric hospital. MATERIAL AND METHOD: We assessed a total of 43 non-consecutive female patients (mean age at questionnaire, 13 years and 1 month and 10 years and 8 months to 14 years and 5 months; mean period of usage of brace, 1 year and 7 months), with adolescent idiopathic scoliosis (AIS), older than 10 years of age until skeletal maturity, with a Risser sign less than 3 and scoliosis between 20 and 45°, treated with thoracolumbosacral orthosis (TLSO) for a period longer than 6 months, and without other comorbidities or previous surgeries, were evaluated. The patients were administered a previously validated to Spanish questionnaire on quality of life (Brace Questionnaire (BrQ); Grivas TB et al.). BrQ is a validated tool and is considered a disease-specific instrument; its score ranges from 20 to 100 points, and higher BrQ scores are associated with better quality of life. RESULTS: The patients reported using the brace for a mean of 17.6 h daily and for a mean period of 1 year and 7 months at the time of the study. Overall, 72% of the study population reported to be in some way psychologically affected by the brace wearing, 56% felt their basic motor activities were affected, 54% felt socialization with their environment was affected, 46% considered their quality of life deteriorated due to pain, and 40% reported conflicts in the school environment. CONCLUSION: Patients with AIS treated with bracing reported a negative impact (53.5% overall) on quality of life and treatment satisfaction in terms of psychological, motor, social, and school environment aspects. An interdisciplinary approach would be important for the integrated psychosocial care of these patients.

8.
Artigo em Inglês | MEDLINE | ID: mdl-30386823

RESUMO

BACKGROUND: Currently, there is little consensus on how or when to discontinue bracing in adolescent idiopathic scoliosis (AIS). An expert spine surgeon national survey could aid in elucidate discontinuation of the brace.Few data have been published on when and how to discontinue bracing treatment in patients with AIS resulting in differences in the management of the condition. The aim of this study was to characterize decision-making of surgeons in the management of bracing discontinuation in AIS. METHODS: An original electronic survey consisting of 12 multiple choice questions was sent to all the members of the National Spine Surgery Society (497 surveyed). Participants were asked about their type of medical practice, years of experience in the field, society memberships, type of brace they usually prescribed, average hours of daily brace wearing they recommended, and how and when they indicated bracing discontinuation as well as the clinical and/or imaging findings this decision was based on. Exclusion criteria include brace discontinued because of having developed a curve that warranted surgical treatment. RESULTS: Of a total of 497 surgeons, 114 responded the survey (22.9%). 71.9% had more than 5 years of experience in the specialty, and 51% mainly treated pediatric patients. Overall, 95.5% of the surgeons prescribed the thoracolumbosacral orthosis (TLSO), indicated brace wearing for a mean of 20.6 h daily. Regarding bracing discontinuation, indicated gradual brace weaning, a decision 93.9% based on anterior-posterior (AP) and lateral radiographs of the spine and physical examination, considered a Risser ≥ IV and ≥ 24 months post menarche. CONCLUSIONS: The results of this study provide insight in the daily practice of spine surgeons regarding how and when they discontinue bracing in AIS. The decision of bracing discontinuation is based on AP/lateral spinal radiographs and physical examination, Risser ≥ IV, regardless of Tanner stage, and ≥ 24 months post menarche. Gradual weaning is recommended.

9.
Foot Ankle Int ; 39(8): 903-907, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29658814

RESUMO

BACKGROUND: Adult-acquired flatfoot deformity (AAFD) is usually due to a combination of mechanical failure of the osteoligamentous complex that maintains the medial longitudinal arch of the foot and attenuation or complete tear of the posterior tibial tendon. Magnetic resonance imaging studies in patients with flatfoot deformities have reported the posterior tibial tendon to be pathologic in up to 100% of patients, the spring ligament in up to 87%, and the deltoid ligament in 33%. Many studies in the literature describe reconstruction of the spring ligament or the deltoid ligament associated with AAFD, but there is no study in which both (spring and deltoid) ligaments are reconstructed at the same time. We describe a novel technique to reconstruct the deltoid ligament and the spring ligament at the same time. METHODS: We described the technique and evaluated 10 consecutive patients with AAFD and insufficient ankle and midfoot ligaments. RESULTS: We found no postoperative complications, stiffness, or loss of correction. CONCLUSION: We present a novel technique to reconstruct the failed deltoid and spring ligament during flatfoot correction. It is unique in that it uses internal brace augmentation with FiberTape® to help and protect the soft tissue healing. LEVEL OF EVIDENCE: Level IV, retrospective case series.


Assuntos
Pé Chato/cirurgia , Articulações do Pé/cirurgia , Ligamentos Articulares/cirurgia , Idoso , Feminino , Pé Chato/diagnóstico por imagem , Pé/diagnóstico por imagem , Pé/cirurgia , Deformidades Adquiridas do Pé/cirurgia , Articulações do Pé/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/métodos , Radiografia , Estudos Retrospectivos
10.
Medisan ; 21(3)mar. 2017. tab
Artigo em Espanhol | LILACS | ID: biblio-841673

RESUMO

Se realizó un estudio epidemiológico analítico, de casos y controles, para identificar los principales factores asociados al abandono del tratamiento ortodóncico en el Servicio de Ortodoncia de la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, en el período comprendido desde septiembre de 2010 hasta julio de 2013. Para ello se crearon 2 grupos: el de los casos, integrado por 193 pacientes de uno u otro sexo, que habiendo iniciado el tratamiento ortodóncico en 2008 por presentar maloclusiones, lo abandonaron en 2010; y el de los controles, conformado por 193 que lo comenzaron también en 2008, pero lo finalizaron en 2010 o 2011. Se determinaron los odds ratio y los intervalos de confianza al 95 por ciento para los factores, en tanto mostraron la mayor fuerza de asociación al abandono del tratamiento: sexo masculino, 6 y más consultas no asistidas y 6 y más consultas pérdidas por falta de recursos. Los principales factores que se asociaron causalmente al abandono del tratamiento ortodóncico fueron los escolares, el sexo masculino, el menor nivel de escolaridad, aparatos removibles y funcionales, aparatos removibles rotos y/o perdidos, consultas entre el ingreso y la instalación de los aparatos y las consultas perdidas por falta de recursos


An analytic epidemiological cases and controls study was carried out, to identify the main factors associated with the orthodonctics treatment cessation in the Orthodontics Service of "Mártires del Moncada" Teaching Provincial Stomatological Clinic in Santiago de Cuba, from September, 2010 to July, 2013. Two groups were created: the cases group, integrated by 193 patients from both sexes that began the orthodontics treatment in 2008 due to malocclusions, and quit it in 2010; and the controls group, conformed by 193 that also began in 2008, but they concluded it in 2010 or 2011. The odds ratio and confidence intervals were determined at 95 percent for the factors, as long as they showed the highest force of association when quitting the treatment: the male sex, 6 and more missed visits and 6 and more lost visits due to lack of resources. The main factors that were causally associated with the orthodontics treatment cessation were the school children, the male sex, the lowest school level, removable and functional braces, broken and/or lost removable braces, visits between admission and teeth bracing and lost visits due to lack of resources


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Ortodontia Corretiva , Pacientes Desistentes do Tratamento , Estética Dentária , Ortodontia , Estudos Epidemiológicos , Equipamentos para Estética
11.
Artigo em Inglês | MEDLINE | ID: mdl-27392841

RESUMO

PURPOSE: The purpose this study was perform a biomechanical evaluation to compare the influence of commercial models of different non-articular proximal forearm orthoses widths (2.5 cm, 5.5 cm, 7.5 cm and 12.0 cm) in the extensor muscle activation, range of motion and grip strength in healthy subjects. METHODS: Was analyzed data from extensor carpi radialis, extensor carpi ulnares and extensor digitorum comunis using surface electromyography, simultaneous with a wrist electrogoniometer MiotecTM and a hydraulic dynamometer JamarTM. The sequence of tests with all the commercial orthoses models was randomized. Statistics analyses were performed by linear model with mixed effects. RESULTS: According to our findings the non-articular proximal forearm orthoses (2.5 cm - narrowest) positioned close to lateral epicondyle provided lesser muscle activation on extensor carpi radialis brevis/longus and extensor digitorum comunis, decreased wrist extension and grip strength during submaximal grip task (p< 0.01). CONCLUSIONS: A narrow non-articular proximal forearm orthosis positioned close to the lateral epicondyle might decrease the extensor muscle activation and therefore could reduce mechanical stress on its insertion, based on this sample. Clinical studies must be conducted to confirm these findings.

12.
J Vis Surg ; 2: 57, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-29078485

RESUMO

Pectus carinatum is a chest wall deformity, sometimes associated with physical signs and symptoms, but always associated to significant psychological distress. Surgical correction used to be the only solution, and was therefore only indicated for the most severe cases. Non-surgical approaches have been developed and improved during the last 15-20 years. A paradigm shift occured when the medical community realized that, despite the wall deformity, the chest wall was not completely rigid, but flexible and capable of remodeling. Several bracing devices and protocols are available as of today. This article will focus specifically in the FMF® Dynamic Compressor System (DCS), which was developed in Argentina in 2001 and is currently used worldwide.

13.
Brasília méd ; 45(1): 10-20, 2008. ilus, tab
Artigo em Português | LILACS-Express | LILACS | ID: lil-496043

RESUMO

Objetivo. Avaliar os resultados de um protocolo de tratamento que incluiu utilização de nova órtese inclinada, de uso contínuo, para abordagem da escoliose idiopática do adolescente, paralelamente à execução de exercícios. A órtese, que possibilita utilização diurna, foi inspirada no colete inclinado de uso noturno de Charleston, ou nightbending brace. Métodos. No período de fevereiro de 1997 a janeiro de 2006 foram avaliados 151 adolescentes com escoliose idiopática, dos quais trinta foram submetidos a um protocolo de tratamento que incluiu utilização de um colete inclinado desenvolvido em Brasília, de uso contínuo, ou seja, não apenas noturno, também diurno, além de exercícios físicos orientados. Tal órtese foi denominada colete inclinado de Brasília. Resultados. Treze pacientes (43,3%) seguiram corretamente o programa proposto e obtiveram melhora média da curva escoliótica de 5,43º. Três (10%) abandonaram o protocolo e apresentaram piora média da escoliose de 9,33º, e 14 (46,7%) seguiram-no de forma irregular e não apresentaram alteração significativa da curva. Conclusão. O colete inclinado de Brasília, acompanhado do cumprimento de protocolo, que incluiu exercícios específicos para cada tipo de curva, mostrou-se efetivo no controle da progressão de curvas toracolombares e lombares. Os achados deste estudo preliminar são encorajadores e justificam investigação continuada. Palavras-chave. Colete; escoliose; adolescente; órtese; exercícios.


Objective. To evaluate the results of a treatment protocol which included the use of a new bending brace for continuous use in the treatment of adolescent idiopathic scoliosis, parallel to the execution of exercises. The orthosis, that allows daytime use, was inspired in the night bending brace of Charleston. Methods. From February 1997 to January 2006, 151 adolescents with idiopathic scoliosis were assessed and thirty of them were submitted to a treatment protocol that included the wearing of a bending brace developed in Brasília, Brazil, for night and day time use, and prescribed exercises. Such an orthosis was named Brasília bending brace. Results. Thirteen patients (43.3%) followed the proposed program correctly and obtained a 5.43º mean improvement of their curves. Three (10%) gave up treatment and showed a 9.33º average worsening of their scoliosis, and 14 (46.7%) followed irregularly the program and did not show any significant change of their curves. Conclusion. The Brasília bending brace, followed by exercises for each type of curve, showed effective control of the progression of thoracolumbar and lumbar scoliosis. The findings of this preliminary study are encouraging and justify continued investigation.

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